I was in Silicon Valley last week for the 10th annual Personalized Medicine World Conference, and the primary themes were quite similar to last year’s event.
On the research side, more phenotypes and data sharing remain the key limiting factors to faster growth in personalized/precision medicine. “Platforms” definitely continue to grow in popularity. Many companies were represented at the conference that have platforms for doing computational drug and IVD discovery. In one panel session, representatives from three such companies were asked by the moderator if there were markets for their platforms, and the response was somewhat tepid.
One representative said that the market is growing, but it’s linear growth not exponential. The primary limiting factor seems to be that there has yet to be an example of a computationally discovered drug making it to the clinic, and that was how all of the panelists defined success for their platforms.
The other type of platform that was well-represented at the conference is the clinical sequencing platform, of which there seem to be many as well. These platforms are designed to give healthcare systems the ability to leverage next generation sequencing for precise characterization of patient genotypes.
These analyses allow physicians to use targeted therapies for off-label indications where rare or previously uncharacterized mutations exist. One example given by a presenter was the use of a HER2 inhibitor in a patient whose colon cancer (in a very rare case) over-expressed that biomarker.
An interesting aspect of being at this conference is how far removed the discussions are from the practical realities faced by most healthcare systems. While folks from Stanford Medical School may take the use of NGS for clinical decision making for granted, their adoption of technology is far removed from that of an oncologist at a typical regional healthcare system.
This was highlighted in a presentation in which barriers to physician adoption of personalized/precision medicine were presented. In one survey, half of the physicians surveyed were unfamiliar with the availabilty of personalized/precision medicines, and almost 80% said they believed genetic testing was too expensive to use in clinical practice.
It’s clear that raising physician awareness is an important need right now. Awareness of the availbility of drugs and the relatively low cost of basic genetic testing. One doesn’t need to install a clinical NGS platform, or even order a $5,000 multi-gene panel, to make use of personalized/precision medicine. A $300-600 single gene test, usually reimbursed, is all that is typically needed to determine if a patient is a candidate for a precision drug.